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State immunization rates vary widely, with generally lower rates of inoculation occurring in states that make it relatively easy to get an exception. Lawmakers in California, Oregon, and Washington state are trying to tighten their laws to allow fewer nonmedical exemptions. Laws allowing religious exemptions have been around longer than those allowing philosophical or “personal belief” exemptions, said Joy Wilson, of the National Conference of State Legislatures. In many but not all states, philosophical exemptions are easier to get than religious exemptions, which typically require parents to cite and explain the religious doctrine in question. Overall, states with philosophical exemptions have 2.5 times the rate of opt-outs than states with only religious exemptions. (Vestal, 2/9)

In a warning issued yesterday, the California Department of Health seemed to state the obvious: “CDPH strongly recommends against the intentional exposure of children to measles,” the agency said. “It unnecessarily places the exposed children at potentially grave risk and could contribute to further spread.” (Kaplan, 2/10)

The California-centered measles outbreak has spread to Solano County, as the number of cases rose to at least 123 in 11 California counties, seven other states and Mexico. The California Department of Public Health reported Monday that there are now 107 cases in the state, with one case now confirmed in Solano County. (Xia, 2/9)

The total is on pace to easily surpass the 644 cases in the United States in 2014, the greatest number since measles was declared eliminated in the United States in 2000. Last week, the CDC reported 102 cases in 14 states. Authorities have said the resurgence is mostly caused by the growing number of people who are declining to vaccinate their children for personal reasons, or delaying the vaccinations. (Bernstein and Dennis, 2/9)